World Stroke Day - October 29th, 2024

In honor of World Stroke Day, October 29th, we thought writing about Stroke and how to recognize the signs and symptoms was fitting.  Most people probably know someone, or they, themselves, may have experienced a stroke.  According to the American Stroke Association (ASA), one in four adults worldwide will suffer a stroke (About Stroke, 2024).  Sadly, it is the 5th leading cause of death in the United States and one of the top causes of disability (ASA, About Stroke, 2024).  The positive side to these grim statistics is that 80% of strokes are preventable.  So, caring for oneself is paramount to keeping a stroke at bay. 

World Stroke Day - Know your Modifiable Risk Factors

A modifiable risk factor is one you can change. Understanding your modifiable risk gives you the knowledge to improve your health and decrease the likelihood of a stroke. Listed below are some modifiable risks that you can review with your healthcare professional:

1. Hypertension (high blood pressure) - Monitor your blood pressure and report your findings to your healthcare provider for assessment to determine if you require treatment for high blood pressure.

2. Weight Management—Even losing a small percentage of weight can improve your health status. Ask your healthcare provider about weight loss options and consult a certified nutritionist to develop a diet plan that works for your lifestyle and food preferences.

3. Diabetes - Take your medication if you are on diabetic medication, watch what you eat, avoid processed, sugary foods, and have your healthcare provider monitor for this disease.

4. Smoking - Deciding to stop smoking is wise. Talk to your healthcare professional if you need help with this and ask for options that would assist you in achieving this goal.

5. Excessive Alcohol Consumption - Limit the amount of alcohol you consume daily. Women are advised to consume no more than one alcoholic beverage per day and men no more than two.

6. Sedentary Lifestyle - Sitting is considered the new smoking. Our bodies were meant to move, so get up and take a walk, dance in your living room, or find an activity that you enjoy that requires movement.

7. Atrial Fibrillation - Afib is an irregular heart rhythm in the upper chambers of your heart that can cause blood clots, leading to a stroke. Talk to your healthcare provider and learn how this condition can be assessed (AHA, Let's talk, 2024).

For a complete list of risk factors, visit the American Stroke Association's website and search for stroke risk factors.

World Stoke Day - Know the Signs and Symptoms

Taking the time to learn and recognize the signs and symptoms of Stroke and seeking treatment immediately can lead to a better outcome.  The ASA (FAST, 2024) reports that those who call 911 at the first sign of a stroke and receive a clot-busting medication within the first 90 minutes of symptom onset are three times more likely to return to their previous level of function or very close to it. Therefore, taking action immediately at the first sign of a stroke can have a significant impact on the stroke survivor's outcome. So, what are the symptoms of a stroke? Let's explore F.A.S.T.

Recognize a Stroke - F.A.S.T.

The American Stroke Association still uses the acronym FAST to alert people of the signs of a stroke.  One of the critical elements of a brain attack(stroke) is that it generally has a sudden onset, so knowing what to look for and how to respond could save someone's life.

F stands for Face.  Look for a facial droop.  Ask the person to smile and count the teeth on either side.  Facial droops can be subtle at times, and counting the teeth can aid in distinguishing if the smile is asymmetrical.

A stands for Arm.  Ask the person to hold out the arms.  Is one drooping down, or can the person not lift one arm?

S stands for Speech.  Ask the person to report a phrase or sentence.  For example, “The sky is blue.”  Are the words slurred or mispronounced? 

T stands for Time.  If any one of these symptoms is present, it is time to call 911.  Stay with the individual until EMS arrives. 

The Importance of Time in Stroke Care

Getting to the hospital as quickly as possible is vital for treating stroke. Depending on the type of stroke, a clot-busting medication can be delivered up to 4.5 hours from symptom onset. Another line of treatment for ischemic strokes is a mechanical thrombectomy, where the clot is removed from the brain. A mechanical thrombectomy can be done for up to 24 hours in select patients.

To help medical personnel determine treatment eligibility, communicate the last time you saw the individual in his or her usual state of health and or when you found the person with stroke symptoms. Here is a hypothetical scenario: At 11:00 a.m., I am having lunch with a friend. We are talking and having a good time. I leave the table for 15 minutes and return and find that my friend has a facial droop at 11:15 a.m. The last known well time is 11:00 a.m. and discovery of symptoms is 11:15 a.m. This information is critical to communicate to EMS and hospital personnel because, again, treatment decisions are based on when the patient was last seen normal or well.

Types of Strokes

There are three main types of strokes. Let's review what they are:

TIA - A TIA is a transient ischemic attack, sometimes referred to as a warning stroke. Someone with a TIA generally improves within minutes, and the brain imaging is negative (it does not show any area of ischemia or blood). However, this does not preclude the person from seeking medical attention. Call 911 at the first sign of symptoms.

Ischemic Stroke - A blood clot in the brain causes an ischemic stroke, and this type of stroke is responsible for 87% of all strokes in the U.S.

Hemorrhagic Stroke - A hemorrhagic stroke or bleeding in the brain accounts for 13% of all strokes and is usually caused by a weakened blood vessel that ruptures. The leading cause of this type of stroke is hypertension. Hemorrhagic strokes carry a higher mortality rate than ischemic or TIA.

When it comes to stroke, time is brain—every second from the onset of symptoms to receiving medical treatment matters. Don’t ignore the signs—call 911 immediately.

But you don't have to wait for symptoms to take action. Now is the time to manage your modifiable risk factors and reduce your chances of having a stroke. Life is short, and time won’t wait. Take charge of your health—schedule a check-up with your healthcare provider today and invest in a long, healthy future!

References

American Stroke Association, (2024). About stroke. Retrieved from https://www.stroke.org/en/about-stroke.

American Stroke Association, (2024). F.A.S.T. infographic. Retrieved from https://www.stroke.org/en/help-and-support

American Stroke Association, (2024). Let's talk about risk factors for stroke. Retrieved from https://www.stroke.org/en/help-and-support/resource-library/lets-talk-about-stroke/risk-factors